Study of mast cells in appendicitis: possible significance
Abstract
Background: To study the mean mast cell count per square mm field in different layers of appendix and to correlate the relationship of these with progression of disease and extent of fibrosis. Also to study the possible significance of mast cell counts with different histological changes and relation with clinical presentation.
Material and Methods: A total of 120 cases of appendix comprised of 20 cases of normal appendix which served as the control and 100 cases of appendicitis in different phase of evolution of the disease were studied for mast cell counts and its significance was assessed in correlation with the histopathological diagnosis as per the evolution of the disease.
Results: Mast cell counts in submucosa were always higher then in mucosa or in muscular propria both in normal and in pathological appendicitis. The increased mast cell count in the mucosal layer was statistically significant in organizing phase than in chronic appendicitis. Submucosal mast cell count did not show any statistically significant difference between different stages of appendicitis and normal appendicitis. The mast cell count in muscularis propria showed statistically significant increase in chronic appendicitis as well as in early acute phase. In appendicitis with grade 2,3 and 4 histology, the total mean mast cell count/sq mm was much higher than in range in grade 1 and grade 5.
Conclusion: In acute phase of inflammation there is decrease in the mast cell. In chronic phase of inflammation there is increase in the mast cell counts. A significant increase of mast cells in muscularis propria during early acute phase of appendicitis which was observed in present study has not been described in literature. This finding needs further evaluation to explain the role of mast cells in the development of early acute inflammatory response.
Downloads
References
Sanyal RK, West GB. The histamine-heparin complex. J Pharm Pharmacol. 1959;11:548-552. doi: 10.1111/j.2042-7158.1959.tb12594.x
Dvorak AM, Monahan RA, Osage JE, Dickersin GR. Crohn's disease: Transmission electron microscopic studies: II. Immunologic inflammatory response. Alterations of mast cells, basophils, eosinophils, and the microvasculature. Human Pathol. 1980;11(6):606-619. doi: 10.1016/s0046-8177(80)80072-4.
Cooke HJ, Fox P, Alferes L, Fox CC, Wolfe SA Jr. Presence of NK1 receptors on a mucosal-like mast cell line, RBL-2H3 cells. Can J Physiol Pharmacol. 1998;76(2):188-193.
Friedman MM, Kaliner M. In situ degranulation of human nasal mucosal mast cells: ultrastructural features and cell-cell associations. J Allergy Clin Immunol. 1985;76(1):70-82. doi: 10.1016/0091-6749(85)90807-3.
Crow J, Howe S. Mast cell numbers in appendices with threadworm infestation. J Pathol. 1988;154(4):347-351. doi: 10.1002/path.1711540411.
Andreou P, Blain S, Du Boulay CE. A histopathological study of the appendix at autopsy and after surgical resection. Histopathol. 1990;17(5):427-431. doi: 10.1111/j.1365-2559.1990.tb00763.x.
Tsuji M, McMahon G, Reen D, Puri P. New insights into the pathogenesis of appendicitis based on immunocytochemical analysis of early immune response. J Pediatr Surg. 1990;25(4):449-452. doi: 10.1016/0022-3468(90)90392-m.
Aravindan KP. Eosinophils in acute appendicitis: possible significance. Indian J Pathol Microbiol. 1997;40(4):491-498.
SV S. Study of mast cell profile In surgically resected Appendices (Doctoral dissertation, Rajiv Gandhi University of Health Sciences).
Naik R, Gowda RJ, Pai MR. Mast cell count in surgically resected appendices. J Ind Med Assoc. 1997;95(11):571-572.
Stead RH, Franks AJ, Goldsmith CH, Bienenstock J, Dixon MF. Mast cells, nerves and fibrosis in the appendix: a morphological assessment. J Pathol. 1990;161(3):209-219. doi: 10.1002/path.1711610307.
Coskun N, Sindel M, Elpek GO. Mast cell density, neuronal hypertrophy and nerve growth factor expression in patients with acute appendicitis. Folia Morphol (Warsz). 2002;61(4):237-243.
Singh UR, Malhotra A, Bhatia A. Eosinophils, mast cells, nerves and ganglion cells in appendicitis. Indian J Surg. 2008;70(5):231-234. doi: 10.1007/s12262-008-0066-0. Epub 2008 Nov 26.
Amber S, Mathai AM, Naik R, Pai MR, Kumar S, Prasad K. Neuronal hypertrophy and mast cells in histologically negative, clinically diagnosed acute appendicitis: a quantitative immunophenotypical analysis. Indian J Gastroenterol. 2010;29(2):69-73. doi: 10.1007/s12664-010-0016-1. Epub 2010 May 5.
Nemeth L, Reen DJ, O'Briain DS, McDermott M, Puri P. Evidence of an inflammatory pathologic condition in “normal” appendices following emergency appendectomy. Arch Pathol & Lab Med. 2001;125(6):759-764.
Mysorekar VV, Chanda S, Dandeka CP. Mast cells in surgically resected appendices. Indian J Pathol Microbiol. 2006;49(2):229-233.
OAI - Open Archives Initiative
